HEADLINES Published August8, 2014 By Staff Reporter

Stroke May Be Linked to Neck Manipulation Therapy

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The American Heart Association released a statement saying that there seems to be new cause to believe that strokes may be linked to therapy that involves neck manipulation. Further studies still need to be conducted about this, however, because there is no concrete evidence proving that neck manipulation does, in fact, cause stroke. Doctors from the Association believe that it is important to let people know about this possibility before they deciding to receive this type of therapy.

Over the past years, there has been an ongoing debate about the merits of neck manipulation as a form of therapy. Recently, one debate discussed how neck manipulation could potentially precipitate a stroke. This claim was associated to the finding that this form of therapy has, in the past, been connected to cervical artery dissection.  This condition is described as the tearing on the walls of the arteries that are located on the neck. The torn tissues particularly pose a threat when they become dislodged from the arterial wall and enter the patient's circulation where they can form a clot and potentially block blood vessels in the brain, causing an ischemic stroke. Cervical artery dissection has been linked to many cases of stroke in adults.

"Most dissections involve trauma, stretch, or mechanical stress. Certain movements that can hyperextend or rotate the neck-such as whiplash, certain sports movements, or even violent coughing or vomiting-can result in CD (cervical dissection), even if they are deemed inconsequential by patient." Lead author, Dr. José Biller, on explaining how dissections can occur.

In neck manipulation therapy, some of the techniques that are used promote sudden movements that rotate an extended the neck, even having been known to use forceful thrusting movements. Dr. Biller said that, "although a cause-and-effect relationship between these therapies and CD has not been established and the risk it's probably low, CD can result in serious neurological injury. Patients should be informed of this association before undergoing manipulation."

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